One of two groups of Florida health care providers that drug maker Gilead accused of making fraudulent 340B-related transactions involving the company’s HIV pre-exposure prophylaxis drugs agreed last week to settle Gilead’s claims against it for $33 million.
A mediation report filed in the lawsuit said the second group of providers reached a settlement in principle with Gilead. Those terms have not been disclosed.
The June 22 consent judgement permanently enjoins the first group of defendants (called the Well Care group) from enrolling individuals in Gilead’s patient assistance program (PAP) or medication assistance program (MAP), prescribing any Gilead medication for which Gilead’s reimbursement will be sought through either program, seeking or accepting reimbursement from either program, and repackaging and dispensing Gilead medication.
Gilead sued the Well Care group and another (called the AJC group) in November 2020. It accused them of “captur[ing] tens of millions of dollars in profits through fraudulent enrollments and reimbursement claims” on Gilead’s HIV pre-exposure prophylaxis drugs Truvada and Descovy.
Gilead accused the defendants, in part, of recruiting “people who earn low incomes or are homeless” for sham wellness checks, prescribing them PrEP medications, and purchasing the drugs at their 340B prices instead of at wholesale acquisition cost (the price Gilead charges under its medication assistance program, MAP, for Trudava and Descovy prescribed for vulnerable patients). Gilead also accused the defendants of buying back dispensed PrEP medications from patients “for as little as $10,” re-dispensing it to others for additional reimbursement, or selling it on the black market.
In a statement yesterday, Gilead said, “Well Care and its president, Mike Peacock, played a central role in the conspiracy by partnering with one of the main defendant groups to expand the fraudulent scheme to Jacksonville and enrich themselves at Gilead’s expense. The Well Care defendants actively recruited and paid thousands of vulnerable Floridians to enroll in Gilead’s free-drug program for PrEP regardless of whether they wanted or needed PrEP medication, putting patient safety at risk.”
“This settlement is another important step toward ensuring public safety and the integrity of Gilead’s free drug program,” the statement continued. “Gilead’s swift and decisive legal action against these fraudulent schemes, as well as the recent update to the PAP/MAP reimbursement model, will help protect Gilead’s ability to provide free life-saving HIV medications to eligible individuals for years to come.”